To the Editor: We are concerned that the sample
of Dr Liu and colleagues1 may not be representative
of US patients who receive dialysis. The median age of patients receiving
incident dialysis in the United States is 64.5 years,2 whereas
in the study by Liu et al it was 57.2 years for all patients and 53.7 years
for those without malnutrition-inflammation complex syndrome (MICS). The renal
transplant rate in the US dialysis population is approximately 5.5 per 100
patient-years.2 One would thus expect 103
in the cohort of Liu et al, but this is substantially fewer than the 153 the
authors reported. Hence, the younger age and the higher transplant rate in
this study indicate a dialysis population that is substantially healthier
than average.